【摘要】 目的探讨细胞因子干扰素-γ(IFN-γ)的含量和腺苷脱氨酶(ADA)的活性在结核和肿瘤患者胸腔积液和外周血中的变化以及对胸腔积液的诊断价值。方法应用酶联免疫吸附试验(ELISA)分别检测36例结核性胸膜炎并胸腔积液和30例恶性肿瘤并胸腔积液患者胸腔积液和外周血中IFN-γ的含量;应用比色法检测两组患者胸腔积液和外周血中ADA的活性,同时检测40例健康对照者外周血中IFN-γ的含量和ADA的活性作为对照。结果结核组患者胸腔积液中IFN-γ的含量明显高于肿瘤组(P<0.001);两组患者与对照者外周血中IFN-γ的含量间差异无显著性意义(P>0.05)。结核组患者胸腔积液中ADA(PADA)的活性明显高于肿瘤组(P<0.05),也高于自身外周血中ADA(SADA)的活性(P<0.001),而且PADA/SADA>1;肿瘤组患者胸腔积液和自身外周血中ADA活性间差异无显著性意义(P>0.05),PADA/SADA<1;结核组患者外周血中ADA的活性高于肿瘤组和对照组(P<0.01);肿瘤组患者与对照者外周血中ADA的活性间差异无显著性意义(P>0.05)。以胸腔积液中IFN-γ的含量300pg/L为临界值,对结核性胸腔积液诊断的灵敏度和特异度分别为97%和94%,约登指数为91%;以胸腔积液中ADA的活性40U/L为临界值,对结核性胸腔积液诊断的灵敏度和特异度分别为97%和98%,约登指数为95%。结论胸腔积液中IFN-γ的含量和ADA的活性可以作为鉴别结核性和肿瘤性胸腔积液的参考依据。更多还原

【Abstract】 Objective To explore the change of interferon-γ(IFN-γ) and adenosine deaminase(ADA) activity levels in pleural effusions and peripheral blood and determine the diagnostic value.Methods 36 cases with tuberculous pleural effusion,30 cases malignant tumor with pleural effusion and 40 healthy persons were recruited,IFN-γ level and ADA activity of pleural effusion and peripheral blood were detected in two suffering groups,INF-γ level and ADA activity of peripheral blood were also detected in healthy group.Results The level of IFN-γ in tuberculous pleural effusion was obviously higher than malignant tumor pleural effusion(P<0.001).The difference of IFN-γ in peripheral blood between the former two( tuberculous group and tumor group) and healthy group was not statistically significant(P>0.05).ADA activity in tuberculous pleural effusion(PADA) were higher than malignant tumor pleural effusion(P<0.05),which is also higher than that in peripheral blood(SADA) (P<0.001),and PADA /SADA>1;The PAD activity in pleural effusion and peripheral blood in tumor group had no significant difference(P>0.05),PADA /SADA<1;SADA in tuberculous group was higher than malignant tumour group and control group(P<0.01);There was no significant difference in SADA between malignant tumor group and control group(P>0.05).When regarded 300 pg/L as critical value of IFN-γ in pleural effusion,the sensitivity and specificity were 97% and 94% respectively for the diagnosing of tuberculous pleural effusion,and the Youden′s index was 91%;40 U/L as critical value of ADA activity in tuberculous pleural effusion,the sensitivity and specificity were 97% and 98% respectively for the diagnosing of tuberculosis,and the Youden′s index was 95%.Conclusion The IFN-γ level and ADA activity can be used to distinguish the tuberculous and malignant tumor pleural effusions.更多还原